TY - JOUR
T1 - Resting-state functional mri for determining language lateralization in children with drug-resistant epilepsy
AU - Phillips, N. L.
AU - Shatil, A. S.
AU - Go, C.
AU - Robertson, A.
AU - Widjaja, E.
N1 - Funding Information:
Received September 25, 2020; accepted after revision February 16, 2021. From the Neurosciences and Mental Health Program (N.L.P., A.S.S., A.R., E.W.), The Hospital for Sick Children, Peter Gilgan Centre for Research and Learning, Toronto, Ontario, Canada; and Department of Psychology (N.L.P.), Division of Neurology (C.G., E.W.), and Department of Diagnostic Imaging (E.W.), The Hospital for Sick Children, Toronto, Ontario, Canada The opinions, results, and conclusions are those of the authors, and no endorsement by the Ontario Brain Institute is intended or should be inferred. This research was supported by EpLink, the Epilepsy Research Program of the Ontario Brain Institute. The Ontario Brain Institute is an independent nonprofit corporation, funded partially by the Ontario government. Please address correspondence to E. Widjaja, MD, Diagnostic Imaging, Hospital for Sick Children, 555 University Ave, Toronto, ON M5G 1X8, Canada; e-mail: [email protected] Indicates article with online supplemental data. http://dx.doi.org/10.3174/ajnr.A7110
Publisher Copyright:
© 2021 American Society of Neuroradiology. All rights reserved.
PY - 2021/7/1
Y1 - 2021/7/1
N2 - BACKGROUND AND PURPOSE: Task-based fMRI is a noninvasive method of determining language dominance; however, not all children can complete language tasks due to age, cognitive/intellectual, or language barriers. Task-free approaches such as resting-state fMRI offer an alternative method. This study evaluated resting-state fMRI for predicting language laterality in children with drug-resistant epilepsy. MATERIALS AND METHODS: A retrospective review of 43 children with drug-resistant epilepsy who had undergone resting-state fMRI and task-based fMRI during presurgical evaluation was conducted. Independent component analysis of resting-state fMRI was used to identify language networks by comparing the independent components with a language network template. Concordance rates in language laterality between resting-state fMRI and each of the 4 task-based fMRI language paradigms (auditory description decision, auditory category, verbal fluency, and silent word generation tasks) were calculated. RESULTS: Concordance ranged from 0.64 (95% CI, 0.48-0.65) to 0.73 (95% CI, 0.58-0.87), depending on the language paradigm, with the highest concordance found for the auditory description decision task. Most (78%-83%) patients identified as left-lateralized on task-based fMRI were correctly classified as left-lateralized on resting-state fMRI. No patients classified as right-lateralized or bilateral on task-based fMRI were correctly classified by resting-state fMRI. CONCLUSIONS: While resting-state fMRI correctly classified most patients who had typical (left) language dominance, its ability to correctly classify patients with atypical (right or bilateral) language dominance was poor. Further study is required before resting-state fMRI can be used clinically for language mapping in the context of epilepsy surgery evaluation in children with drug-resistant epilepsy.
AB - BACKGROUND AND PURPOSE: Task-based fMRI is a noninvasive method of determining language dominance; however, not all children can complete language tasks due to age, cognitive/intellectual, or language barriers. Task-free approaches such as resting-state fMRI offer an alternative method. This study evaluated resting-state fMRI for predicting language laterality in children with drug-resistant epilepsy. MATERIALS AND METHODS: A retrospective review of 43 children with drug-resistant epilepsy who had undergone resting-state fMRI and task-based fMRI during presurgical evaluation was conducted. Independent component analysis of resting-state fMRI was used to identify language networks by comparing the independent components with a language network template. Concordance rates in language laterality between resting-state fMRI and each of the 4 task-based fMRI language paradigms (auditory description decision, auditory category, verbal fluency, and silent word generation tasks) were calculated. RESULTS: Concordance ranged from 0.64 (95% CI, 0.48-0.65) to 0.73 (95% CI, 0.58-0.87), depending on the language paradigm, with the highest concordance found for the auditory description decision task. Most (78%-83%) patients identified as left-lateralized on task-based fMRI were correctly classified as left-lateralized on resting-state fMRI. No patients classified as right-lateralized or bilateral on task-based fMRI were correctly classified by resting-state fMRI. CONCLUSIONS: While resting-state fMRI correctly classified most patients who had typical (left) language dominance, its ability to correctly classify patients with atypical (right or bilateral) language dominance was poor. Further study is required before resting-state fMRI can be used clinically for language mapping in the context of epilepsy surgery evaluation in children with drug-resistant epilepsy.
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U2 - 10.3174/ajnr.A7110
DO - 10.3174/ajnr.A7110
M3 - Article
C2 - 33832955
AN - SCOPUS:85110674929
SN - 0195-6108
VL - 42
SP - 1299
EP - 1304
JO - American Journal of Neuroradiology
JF - American Journal of Neuroradiology
IS - 7
ER -